Ocrelizumab and Hyaluronidase side effects: what 7,314 FDA adverse event reports show
Drug class
CD20-directed Cytolytic Antibody
Label matched
Ocrelizumab (Ocrevus)
Who reports
7,314 reports · 64% serious · 237 with death outcome · 70% female
Used for
OCREVUS is indicated for the treatment of: Relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults Primary progressive MS, in adults Relapsing-remitting MS, in pediatric patients 10 years of age and older who weigh 25 kg or more.
What it is
Ocrelizumab is a recombinant humanized monoclonal antibody directed against CD20-expressing B-cells. Ocrelizumab is a glycosylated immunoglobulin G1 (IgG1) with a molecular mass of approximately 145 kDa.
Boxed warning
None in the current label
Causality screen of the 8 strongest signals
What the badges mean
- Labeled (related wording) The label describes this effect under different wording (e.g. 'neutropenia' for 'neutrophil count decreased'). Treated as known.
- Likely indication confounding The term appears in the label's indications: reports probably describe the disease being treated (or its progression), not a drug effect. Classic confounding by indication.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only and flags pairs whose reports are unusually skewed by sex or come mostly from consumers rather than clinicians. 2 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Injection site erythema (redness where injected) | 45 | 19.0 14.4–25.0ROR 21.2 · χ² 753 / p 6e-166 | 18.8 EB05 14.6 · IC025 +3.5 3/3 methods agree | Labeled (related wording) related wording | – | no trial data cached |
| Multiple sclerosis relapse | 21 | 15.8 10.4–24.0ROR 16.6 · χ² 278 / p 1e-62 | 15.3 EB05 10.2 · IC025 +2.8 3/3 methods agree | Labeled (related wording) related wording | – | no trial data cached |
| Injection site reaction | 18 | 13.7 8.7–21.4ROR 14.2 · χ² 199 / p 2e-45 | 12.8 EB05 8.0 · IC025 +2.6 3/3 methods agree | Not in label — unassessed | – | no trial data cached |
| Injection site pain (pain where injected) | 59 | 10.1 8.0–12.8ROR 11.7 · χ² 482 / p 3e-107 | 9.8 EB05 7.8 · IC025 +2.8 3/3 methods agree | Labeled (related wording) related wording | – | no trial data cached |
| Injection site swelling | 13 | 8.9 5.2–15.2ROR 9.2 · χ² 84 / p 2e-20 | 7.4 EB05 4.4 · IC025 +1.8 3/3 methods agree | Not in label — unassessed | – | no trial data cached |
| Injection site rash | 5 | 8.6 3.6–20.5ROR 8.7 · χ² 26 / p 1e-7 | 5.5 EB05 2.4 · IC025 +0.8 3/3 methods agree | Labeled (related wording) related wording | – | no trial data cached |
| Multiple sclerosis | 7 | 7.6 3.6–15.8ROR 7.7 · χ² 34 / p 3e-9 | 5.4 EB05 2.8 · IC025 +1.1 3/3 methods agree | Likely indication confounding term in indications; also in warnings | – | no trial data cached |
| Injection site pruritus | 8 | 6.3 3.1–12.4ROR 6.4 · χ² 30 / p 2e-8 | 4.8 EB05 2.6 · IC025 +1.0 3/3 methods agree | Labeled (related wording) related wording | – | no trial data cached |
Trial evidence (ClinicalTrials.gov)
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Injection site pain (pain where injected) | 59 | 10.1 8.0–12.8ROR 11.7 · χ² 482 / p 3e-107 | 9.8 EB05 7.8 · IC025 +2.8 3/3 methods agree | Labeled (related wording) related wording | – | no trial data cached |
| Injection site erythema (redness where injected) | 45 | 19.0 14.4–25.0ROR 21.2 · χ² 753 / p 6e-166 | 18.8 EB05 14.6 · IC025 +3.5 3/3 methods agree | Labeled (related wording) related wording | – | no trial data cached |
| Multiple sclerosis relapse | 21 | 15.8 10.4–24.0ROR 16.6 · χ² 278 / p 1e-62 | 15.3 EB05 10.2 · IC025 +2.8 3/3 methods agree | Labeled (related wording) related wording | – | no trial data cached |
| Injection site reaction | 18 | 13.7 8.7–21.4ROR 14.2 · χ² 199 / p 2e-45 | 12.8 EB05 8.0 · IC025 +2.6 3/3 methods agree | Not in label — unassessed | – | no trial data cached |
| Injection site swelling | 13 | 8.9 5.2–15.2ROR 9.2 · χ² 84 / p 2e-20 | 7.4 EB05 4.4 · IC025 +1.8 3/3 methods agree | Not in label — unassessed | – | no trial data cached |
| Injection site pruritus | 8 | 6.3 3.1–12.4ROR 6.4 · χ² 30 / p 2e-8 | 4.8 EB05 2.6 · IC025 +1.0 3/3 methods agree | Labeled (related wording) related wording | – | no trial data cached |
| Multiple sclerosis | 7 | 7.6 3.6–15.8ROR 7.7 · χ² 34 / p 3e-9 | 5.4 EB05 2.8 · IC025 +1.1 3/3 methods agree | Likely indication confounding term in indications; also in warnings | – | no trial data cached |
| Injection site rash | 5 | 8.6 3.6–20.5ROR 8.7 · χ² 26 / p 1e-7 | 5.5 EB05 2.4 · IC025 +0.8 3/3 methods agree | Labeled (related wording) related wording | – | no trial data cached |
| Injection site discolouration | 3 | 12.6 4.1–38.9ROR 12.7 · χ² 21 / p 2e-6 | 6.4 EB05 2.0 · IC025 +0.2 3/3 methods agree | Not in label — unassessed | – | no trial data cached |
| Injection site discomfort | 3 | 15.1 4.9–46.7ROR 15.2 · χ² 27 / p 1e-7 | 7.9 EB05 2.2 · IC025 +0.3 3/3 methods agree | Labeled (related wording) related wording | – | no trial data cached |
Unlabeled candidate signals
Every screened signal with n ≥ 20 was either labeled, an indication term, or an artifact pattern — no unlabeled candidate stood out in the top signals.
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Ocrelizumab and Hyaluronidase?
In FDA FAERS, the most frequently co-reported reaction terms for Ocrelizumab and Hyaluronidase are injection site pain, injection site erythema, multiple sclerosis relapse, injection site reaction, injection site swelling, injection site pruritus. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Ocrelizumab and Hyaluronidase have an FDA boxed warning?
No. The FDA label retrieved for Ocrelizumab and Hyaluronidase has no boxed warning; see the label's Warnings and Precautions for the recognised risks.
Do FAERS signals prove that Ocrelizumab and Hyaluronidase causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID 9da42362-3bb5-4b83-b4bb-b59fd4e55f0d, effective 20260514; matched on
openfda.generic_name.exact:"OCRELIZUMAB") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 10 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
- Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath
Page generated 2026-10-08. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.